OBJECTIVE:To systematically review the efficacy of L-carnitine in the treatment of heart failure,and provide evi-dence-based reference for clinical treatment. METHODS:Retrieved from Cochrane Library,PubMed,Medline,CJFD and Wanfang Database, randomized controlled trials(RCT)about the efficacy of L-carnitine in the treatment of heart failure were collected. Me-ta-analysis was performed by using Rev Man 5.1 software after data extraction and quality evaluation. RESULTS:Totally 42 RCTs were enrolled,involving 3 494 patients. Results of Meta-analysis showed,L-carnitine can significantly improve the effective rate [OR=4.07,95%CI(3.16,5.25),P<0.001],increase left ventricular ejection fraction(LVEF)[MD=4.49,95%CI(3.49,5.49),P<0.001],decrease brain natriuretic peptide(BNP)levels [MD=-130.17,95%CI(-193.81,-66.52),P<0.001] and improve walk-ing distance in 6 minutes [MD=46.12,95%CI(35.72,56.51),P<0.001],the differences were statistically significant. CONCLU-SIONS:L-carnitine has good efficacy in the treatment of heart failure,it can significantly improve LVEF,decrease BNP level and increase walking distance in 6 minutes.

OBJECTIVE:To provide reference for improving the teaching quality of the course of Drug Abuse and ADR Moni-toring in pharmacy master degree candidates. METHODS:In Pharmacy College of Jilin University,traditional teaching method was adopted among pharmacy master degree candidates of grade 2014(n=30,control group);case teaching method was adopted for the course of Drug Abuse and ADR Monitoring among those of grade 2015 (n=32,observation group). The teaching effects were evaluated by questionnaire and examination. RESULTS:Theoretical examination result and case analysis score as well as the rate of excellent case analysis score in observation group were all significantly higher than control group,with statistical signifi-cance (P<0.05). The satisfaction degree of observation group was significantly higher than that of control group in respects of teaching methods,arousing interest in classroom learning,establishing the awareness of safe and rational drug use,with statistical significance (P<0.05). CONCLUSIONS:For the course of Drug Abuse and ADR Monitoring in pharmacy master degree candi-dates,case teaching method improves students'exam results,stimulates students'interest and enthusiasm,promotes the establish-ment of students'safe and rational drug use consciousness and improves teaching quality.

AIM:To investigate the effects of brain-derived neurotrophic factor(BDNF)on extracellular proteolytic enzymes including matrix metalloproteinases(MMPs)and serine proteases,in particular,the urokinase-type plasminogen activator(uPA)-plasmin system in a human umbilical vein endothelial cell(HUVEC)model.METHODS:The HUVEC was activated with different doses of BDNF(25-200 ?g/L)for different time period(6-48 h).Reverse transcriptase-polymerase chain reaction(RT-PCR)was used to assay MMP-2,MMP-9,TIMP-1,and TIMP-2 mRNA in HUVEC.The cultured conditioned medium was analyzed for MMP and uPA activity by gelatin zymography and fibrin zymography,respectively.uPA,PAI-1,TIMP-1,and TIMP-2 were quantified by Western blotting analysis.RESULTS:The stimulation of serum-starved HUVECs with BDNF caused marked increase in MMP-2 and MMP-9 mRNA expression and induced the pro-MMP-2 and pro-MMP-9 activation without significant differences in proliferation.However,BDNF had no effect on TIMP-1 and TIMP-2 production.BDNF increased uPA and PAI-1 production in a dose dependent manner up to 100 ?g/L,while effects of 200 ?g/L were approximately equal to those of 100 ?g/L.BDNF stimulated uPA and PAI-1 production beyond that in control cultures from 12 h until 48 h after BDNF addition.Protease activity for uPA was also increased by BDNF in a dose dependent manner.CONCLUSION:BDNF activates MMP and uPA/PAI-1 proteolytic network in HUVEC.

Objective To analyze and compare the imaging characteristics of contrast-enhanced ultrasound (CEUS) and contrast enhanced magnetic resonance imaging (CEMRI) in diagnosing hepatic epithelioid hemangioendothelioma (HEHE) for improving radiological diagnostic accuracy.Methods The imaging characteristics of CEUS and dynamic CEMRI in 17 patients with histopathological diagnosis of HEHE on specimens obtained after surgical resection or fine needle biopsy were retrospectively analyzed and compared.Results On CEUS,20 lesions in 13 patients demonstrated different enhancement patterns in the arterial phase:13 lesions (65.0％) displayed gross enhancement and 7 lesions (35.0％) displayed a rimlike enhancement.Synchronous enhancement was observed in 17 lesions (85.0％) and rapid enhancement was observed in 3 lesions (15.0％).All these 20 lesions manifested as a hypoechoic mass in the portal venous and delayed phases.Other characteristics included speculated enhancement in the inner margin of the lesions and a vessel sign.On CEMRI,45 lesions (71.4％) manifested slight enhancement in the arterial phase and continuous enhancement in the portal venous and delayed phases.The remaining 18 lesions (28.6％) manifested no enhancement in the arterial phase but progressive enhancement in the portal venous and delayed phases.47 lesions (74.6％) displayed a rim-like enhancement and 16 lesions (25.4％) displayed gross enhancement.Other imaging characteristics included a halo sign,a lollipop sign,a capsular retraction sign or avessel sign.Conclusions On CEUS,characteristic manifestations of HEHE were synchronous enhancement with a quick wash-out.At peak time,the enhancement degree was equal to the normal liver parenchyma.On CEMRI,the main radiological feature of HEHE was a rim-like enhancement.In the arterial phase,the enhancement degree was not high and there was either a continuous enhancement or a progressive enhancement in the portal venous and delayed phases.Furthermore,HEHE lesions always occurred under the liver capsule and showed acapsular retraction sign,ahalo sign,a lollipop sign or a vessel sign.The combination of CEUS and CEMRI helped to improve the diagnostic rate and contributed to selection of clinical treatment.

Purpose To analyze and compare the imaging characteristics of contrastenhanced ultrasound (CEUS) and dynamic contrast-enhanced CT for hepatic epithelioid hemangioendothelioma (HEHE) diagnosis.Materials and Methods The imaging characteristics of CEUS and dynamic contrast-enhanced CT performed on 16 patients with pathological-confirmed HEHE were retrospectively analyzed.Dynamic contrast-enhanced CT was performed on 5 patients,real-time CEUS was performed on 8 patients,and both examinations were performed on 3 patients.Results On CEUS,14 lesions were selected from 11 HEHE cases.In the case of enhancement mode,5 lesions displayed ringenhancement,and 9 lesions displayed global enhancement;in the case of arterial phase,11 lesions were synchronously enhanced,and 3 lesions were rapidly enhanced compared with liver parenchyma;in the case of peak time,hyper-enhancement,iso-enhancement and hypo-enhancement were observed in 2 lesions,9 lesions and 3 lesions,respectively;all 14 lesions manifested hypoechoic mass in portal phase and delayed phase.On dynamic contrast-enhanced CT,29 lesions were found in 8 HEHE cases.In the case of arterial phase,9 lesions (31.0％) showed slight inhomogeneous enhancement,4 lesions (13.8％) showed no obvious enhancement and 16 (55.2％) lesions showed slight edge enhancement;all 29 lesions presented continuous hypo-enhancement in delayed phase.Conclusion Both CEUS and dynamic contrast-enhanced CT have respective characteristic manifestations,and are of high value for the diagnosis of HEHE.

The effects of fenofibrate on plasminogen activator inhibitor-1 (PAI-1) expression in human umbilical endothelial cell-derived transformed cell line--ECV 304 cells were investigated. ECV 304 cells were incubated with different concentrations of fenofibrate (0, 10, 50, 100 micromol/L) for 24 h. PAI-1 mRNA and protein was detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot respectively. PAI-1 antigenic content of endothelial cells was measured by using ELISA. Fenofibrate could inhibit the PAI-1 mRNA and protein expression and reduce PAI-1 antigenic content dependently. After treatment with fenofibrate (10 micromol/L), the expression levels of PAI-1 mRNA and protein were 0.65 +/- 0.05 and 0.96 +/- 0.11 respectively, significantly lower than in the control group (0.78 +/- 0.03 and 1.21 +/- 0.15, respectively, P<0.05). PAI-1 antigenic contents (24.52 +/- 8.39) in ECV304 cells treated with 10 micromol/L fenofibrate were significantly lower than those in the control group (6.98 +/- 5.12, P<0.05). It was concluded that fenofibrate inhibited the expression of PAI-1 mRNA in ECV304 cells, and reduce the protein expression and the antigenic content of PAI-1, suggesting that fenofibrate may have an antiatherosclerotic effect on endothelial cells by PAI-1 pathway.

Objective To analyze the influence of hepatosteatosis on pancreatic β-cell function in type 2 diabetes mellitus (T2DM).Methods A total of 213 subjects with T2DM from Metabolic Disease Hospital,Tianjin Medical University from January 2013 to December 2013 were included in the study.Non-alcoholic fatty liver disease (NAFLD) was diagnosed with abdominal ultrasonography.Patients were divided into two groups:T2DM with NAFLD and T2DM without NAFLD.ALT,AST,γ-glutamyltransferase,serum lipid,glycosylated hemoglobin A1 c (HbA1c),fructosamine,fasting glucose,insulin and 2 hours plasma glucose,insulin after 75g glucoseload were detected.The insulin resistance and β-cell function were assessed by HOMA-IR and HOMA-β.Results Among the 213 T2DM subjects,51％ (108 cases) were with NAFLD.The HOMA-IR [4.76 (2.83,7.21) vs 2.79 (1.76,4.37),P ＜ 0.05] and HOMA-β [49.18 (37.78,85.09) vs 29.50 (18.09,45.54),P ＜ 0.05] were significantly higher in T2DM with NAFLD than those in T2DM alone.Within subjects with T2DM and NAFLD,the HOMA-IR [6.28 (2.87,8.17) vs 2.95 (2.07,3.66) P ＜ 0.05] and HOMA-β [59.18 (37.78,85.09) vs 30.59 (28.56,34.49),P ＜ 0.05] levels were higher in subjects with normal liver function than those with abnormal liver function.Conclusions T2DM patients with NAFLD have severer insulin resistance than those without NAFLD.The β-cell function of those patients was compensatory increased,which was decreased in subjects with abnormal liver function.

AIM: To study the expression of tissue factor (TF) in cerebral microvascular thrombosis and its dynamic changes in rats. METHODS: 50 female SD rats were randomized to control group, 2, 4, 6, and 24 hours after thrombosis groups, 10 rats in each group. The model of cerebral microvascular thrombosis was induced by photo-chemical method. ELISA and immunohistochemistry methods were used to observe the changes of TF contents in blood plasma and the expression of TF in cerebral microvascular in each group. RESULTS: Cerebral thrombosis was induced by photo-chemical method successfully. The TF content in plasma was obviously higher in 4 h and 6 h groups than that in control group (P

In this study, we administered a modified schedule of weekly intravenous Bortezomib at 1.6 mg/m(2) with dexamethasone (BD) and compared it to the standard 1.3 mg/m(2) twice-weekly BD regimen in Chinese patients with newly diagnosed multiple myeloma (MM). We assessed the difference in efficacy, safety profile and survival between the once-weekly and twice-weekly cohorts (13 vs. 24 patients). The over response rate was similar with both arms of the study, being 77% in the once-weekly schedule and 74.9% in the twice-weekly schedule (P=0.690). The median overall survival was not reached in either schedule. Also, the median progression-free survival and duration of response of the once-weekly schedule did not significantly differ from those of the twice-weekly schedule (8 months vs.10 months, P=0.545 and 6 months vs.7 months, P=0.467 respectively). Peripheral sensory neuropathy and grade 3/4 hematologic toxic effects were more frequently reported in the twice-weekly schedule than the once-weekly schedule, but there was no statistically significant difference. This preliminary experience in Chinese patients with newly diagnosed MM indicated that once-weekly infusion of Bortezomib plus dexamethasone may improve safety without affecting outcome.